Academic journal article Social Work

A Constructive Perspective on Clinical Social Work Practice with Ethnically Diverse Clients

Academic journal article Social Work

A Constructive Perspective on Clinical Social Work Practice with Ethnically Diverse Clients

Article excerpt

Research has found that virtually all therapeutic approaches are equally effective (Smith, Glass, & Miller, 1980). The one thing essential to therapeutic success, regardless of theoretical orientation, is a good working relationship between the clinician and the client (Frank, 1982; Marziali & Alexander, 1991). Integral to establishing and maintaining such a relationship is the clinician's use of self in the application of a specific approach or technique (Lambert, Bergin, & Collins, 1977; McConnaughy, 1987).

Awareness of use of self is especially important for clinicians working with clients ethnically different from themselves. Much has been written on ethnicity issues in clinical practice (Ho, 1987; Pinderhughes, 1989), with some emphasis given to the clinician's use of self in cross-cultural practice (Boyd-Franklin, 1989; Pinderhughes, 1989). Although the use of self by the clinician in client empowerment has been discussed (Baldwin & Satir, 1987; Pinderhughes, 1989), it has not been sufficiently operationalized in the broader context of cross-cultural clinical social work practice.

In cross-cultural clinical practice the importance of considering the client's worldview (conception of reality) vis-a-vis the clinician's has been noted (Ibrahim, 1985). One's conception of reality is constructed through social interaction with significant others, and ethnicity is a critical factor in this process (Berger & Luckman, 1966; Hoffman, 1988). The fact that reality is socially constructed is the basis of the constructivist perspective in family therapy and social work (Hoffman, 1988; Jones, Greene, & Ruhala, 1993; Witkin, 1991).

Constructivism

Constructivism holds that people do not discover reality but rather use language to construct a conception of reality through social interaction (Goolishian & Winderman, 1988). A person's conception of reality consists of the meanings he or she has given to his or her interpretation of the world (Goolishian & Winderman, 1988). Meanings are coconstructed in the dialogue between two people (or more) in which ideas are exchanged (Goolishian & Winderman, 1988).

Through conversations with numerous people over a lifetime, one's reality continually evolves. One major aspect of this socially constructed reality is one's sense of self - self-concept (Gergen, 1985). Integral to the social construction of the self are experiences in the family of origin (Reiss, 1981; Wamboldt & Wolin, 1989). According to Minuchin (1979), the family of origin is the matrix (context) for the development of the definition of self.

Also important in the socially constructed reality of the self is one's ethnic and cultural heritage (Pinderhughes, 1989). Different ethnic groups have different values, beliefs, rituals, and traditions that form the context of the family of origin. Just as the family is the context for one's construction of self, one's ethnic and cultural heritage provides the larger context for the family's construction of its reality. Having a sense of and connection with one's ethnic and cultural heritage is important to positive self-esteem and mental health (Pinderhughes, 1989).

Society is assumed to provide the larger context for the construction of ethnic identity. Experience shows, however, that the unique attributes of groups in the minority tend to be devalued by those in the majority as a way of coping with perceived threats from the minority. Consequently, a person from an ethnic group in the minority may construct a sense of self that is influenced by this devaluation, lack of power, and discrimination in the societal context.

Constructivism and Clinical Practice

Consistent with the constructivist orientation is the narrative approach to clinical practice (Borden, 1992; Howard, 1991; Laird, 1989). Several authors have mentioned the connection between constructivism and narrative theory in their writings (Dean & Fleck-Henderson, 1992; Gallant, 1993; Hoffman, 1991). …

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